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Developmental dysplasia of the hip: Treatment and outcome

Author
Scott B Rosenfeld, MD
Section Editor
William Phillips, MD
Deputy Editor
Mary M Torchia, MD

INTRODUCTION

Developmental dysplasia of the hip (DDH) describes a spectrum of conditions related to the development of the hip in infants and young children. It encompasses abnormal development of the acetabulum and proximal femur and mechanical instability of the hip joint (table 1). (See "Developmental dysplasia of the hip: Epidemiology and pathogenesis", section on 'Terminology'.)

Newborns often have physiologic laxity of the hip and immaturity of the acetabulum during the first few weeks of life. In most cases, the laxity resolves, and the acetabulum proceeds to develop normally. With assessment of risk factors, serial physical examination of the hips, and appropriate use of imaging studies, most children with pathologic hips can be correctly diagnosed and treated without long-term sequelae. (See "Developmental dysplasia of the hip: Clinical features and diagnosis".)

Typical DDH, which generally occurs in otherwise healthy infants, will be the focus of this topic review. Hip dysplasia and instability also occur in association with other conditions. Teratologic hip dysplasia occurs in association with various syndromes (eg, Ehlers Danlos, Down syndrome, arthrogryposis), and neuromuscular hip dysplasia occurs when there is weakness and/or spasticity in some or all of the hip muscle groups (eg, in spina bifida or cerebral palsy). The diagnosis and management of teratologic and neuromuscular hip dysplasia differ from the diagnosis and management of hip dysplasia in otherwise healthy infants.

Treatment of DDH is initiated with referral to a pediatric orthopedic surgeon or other orthopedic surgeon who is familiar with the diagnosis and treatment of DDH. The treatment and outcome of DDH in otherwise healthy children will be reviewed here. The epidemiology, pathogenesis, natural history, clinical features, and diagnosis are discussed separately. (See "Developmental dysplasia of the hip: Epidemiology and pathogenesis" and "Developmental dysplasia of the hip: Clinical features and diagnosis".)

TERMINOLOGY

Specific terms describing the position, stability, and shape of the hip in infants and children with developmental dysplasia of the hip are defined below:

                            

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Literature review current through: Nov 2016. | This topic last updated: Thu Oct 13 00:00:00 GMT+00:00 2016.
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